Organization
E T DRUGS INC
Active
Other names
MILLER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ETHAN ASEDO BS (PRES)
(718) 442-4127
Entity
Organization
Contact information
Practice address
173 BROAD ST, STATEN ISLAND, NY 10304-2057
(718) 447-4127
(718) 273-1232
Mailing address
173 BROAD ST, STATEN ISLAND, NY 10304-2057
(718) 447-4127
(718) 273-1232
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
017642
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00745331
—
NY
01
—
2061728
PK
—
Enumeration date
08/31/2006
Last updated
06/13/2016
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